CT联合定量超声在围绝经期女性胸肋关节痛患者骨质疏松症筛查中的应用探讨

目的探讨计算机断层扫描(CT)联合定量超声(QUS)在围绝经期女性胸肋关节痛患者骨质疏松症(OP)筛查中的应用效果。方法回顾性分析2016年12月至2018年11月医院收治的130例围绝经期女性胸肋关节痛患者的临床资料,均接受CT和QUS检测。以双能X线骨密度仪诊断结果为“金标准”,将患者分为OP组和非OP组,对比2组患者CT和QUS检测结果[宽带超声振幅衰减(BUA)、硬度指数(SI)及T-score],绘制受试者工作曲线(ROC),分析并对比CT、QUS单独及联合检测对围绝经期女性胸肋关节痛患者OP筛查意义。结果OP组QCT值、BUA水平、SI、T-score值均低于非OP组,且差异有统计学意义(P<0.05);CT对围绝经期女性胸肋关节痛患者OP筛查最佳截断点为80.00mg/cm^3;CT与QUS联合检测筛查OP的灵敏度、特异度和准确度分别为73.33%、97.39%、94.62%,特异度和准确度均高于单独检测,且联合检测筛查OP的AUC为0.950,高于单独检测。结论与单独CT和QUS检测相比,联合检测对围绝经期女性胸肋关节痛患者OP具有高特异度和准确度,具有较高的诊断价值,可作为围绝经期女性胸肋关节痛患者OP筛查工具。

Application of CT Combined with Quantitative Ultrasound in the Screening of Osteoporosis in Perimenopausal Women with Thoracic Ioint Pain

Objective To investigate the effect of computed tomography(CT)combined with quantitative ultrasound(QUS)in the screening of osteoporosis(OP)in perimenopausal women with thoracic joint pain.Methods The clinical data of 130 perimenopausal women with chest-costal pain admitted to our hospital from December 2016 to November 2018 were retrospectively analyzed.All patients underwent CT and QUS examinations.According to the diagnostic results of dual-energy X-ray absorptiometry,the patients were divided into the OP and non-OP groups as the gold standard.The results of CT and QUS[broadband ultrasound amplitude attenuation(BUA),hardness index(SI)and T-score]were compared between the two groups.The receiver operating curve(ROC)was drawn to analyze the significance of CT,QUS alone,and combined detection for OP screening in perimenopausal women with chest-costal pain.Results QCT,BUA,SI,and T-score in the OP group were lower than those in the non-OP group(P<0.05).The best cut-off point for OP screening in perimenopausal women with chest-costal pain by CT was 80.00 mg/cm3.The sensitivity,specificity,and accuracy of combined detection of CT and QUS for OP screening were 73.33%,97.39%,and 94.62%,respectively.The specificity and accuracy of combined detection of CT and QUS were higher than that of single detection,and the AUC of combined detection for OP was 0.950,higher than that of single detection.Conclusion Compared with CT and QUS alone,the combined detection of OP in perimenopausal women with chest-costal pain has high specificity and accuracy and has high diagnostic value.It can be used as a screening tool for OP in perimenopausal women with chest-costal pain.